Provider Demographics
NPI:1689626228
Name:RIGELMAN, GREGORY A (CRNA)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:A
Last Name:RIGELMAN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50150
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98015-0150
Mailing Address - Country:US
Mailing Address - Phone:425-772-2233
Mailing Address - Fax:
Practice Address - Street 1:345 COLLEGE ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1013
Practice Address - Country:US
Practice Address - Phone:360-456-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30000274367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR430057583OtherRAILROAD MEDICARE
WA430061582OtherRAILROAD MEDICARE
WA430057582OtherRAILROAD MEDICARE
WA430023983OtherRAILROAD MEDICARE
WAGAB20609Medicare PIN
WA430061582OtherRAILROAD MEDICARE
WAG8860882Medicare PIN
WAG000355076Medicare PIN
WAG000165112Medicare PIN
WAG000985520Medicare PIN
OR430057583OtherRAILROAD MEDICARE
ORR107567Medicare PIN
WAG8860886Medicare PIN